The prevalence of abnormal results of conventional coagulation tests on admission to a trauma center.
BACKGROUND
Several groups have reported that a fraction of severely injured patients have abnormal coagulation tests at presentation to trauma centers, even in the absence of significant crystalloid resuscitation. These patients have high mortality, but their prevalence in trauma populations is not clear from the reports.


METHODS
Records of all patients admitted to a large urban trauma center during 2000 through 2006 were searched for early measures of common coagulation tests and in-hospital mortality.


RESULTS
Abnormal coagulation tests were increasingly frequent with increasing injury severity, ranging from 5 to 43 percent for the prothrombin time as the injury severity scores (ISSs) increased from 5 to more than 45 and 4 to 18 percent for platelet counts of less than 150 x 10(9) per L. Abnormal coagulation tests were associated with excess mortality even below conventional transfusion triggers and this was especially true for the partial thromboplastin time.


CONCLUSIONS
Abnormal coagulation tests are common in severely injured patients. Even in the moderately injured, they are associated with higher mortality.
Hess
John R
JR
Departments of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA. jhess@umm.edu
Lindell
Allison L
AL
Stansbury
Lynn G
LG
Dutton
Richard P
RP
Scalea
Thomas M
TM
D000328:Adult; D003951:Diagnostic Errors; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D015995:Prevalence; D011517:Prothrombin Time; D012151:Resuscitation; D014193:Trauma Centers; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy